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Carbon dioxide insufflation during endoscopic colorectal stenting for malignant colorectal obstruction: a randomized controlled trial

ABSTRACT: Primary outcome(s): change of abdominal symptoms and abdominal circumference, before and after stenting procedure Study Design: Observational Study Model : Case-control, Time Perspective : Prospective, Enrollment : 50, Biospecimen Retention : Not collect nor Archive

DISEASE(S): Neoplasms

PROVIDER: 2511459 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Colorectal cancer and obesity

Project description:Primary outcome(s): Abdominal visceral fat volume;Body mass index Study Design: Observational Study Model : Case-control, Time Perspective : Cross-sectional, Enrollment : 250, Biospecimen Retention : Collect & Archive- Sample with DNA, Biospecimen Description : colorectal cancer

| 2509226 | ecrin-mdr-crc

Difficult colonoscopy: air, carbon dioxide, or water insufflation?

Project description:Background/aimsThis study aimed to compare tolerance to air, carbon dioxide, or water insufflation in patients with anticipated difficult colonoscopy (young, thin, obese individuals, and patients with prior abdominal surgery or irradiation).MethodsPatients with body mass index (BMI) less than 18 kg/m2 or more than 30 kg/m2, or who had undergone previous abdominal or pelvic surgeries were randomized to air, carbon dioxide, or water insufflation during colonoscopy. The primary endpoint was cecal intubation with mild pain (less than 5 on visual analogue scale [VAS]), without use of sedation.ResultsThe primary end point was achieved in 32.7%, 43.8%, and 84.9% of cases with air, carbon dioxide and water insufflation (P<0.001). The mean pain scores were 5.17, 4.72, and 3.93 on the VAS for air, carbon dioxide, and water insufflation (P<0.001). The cecal intubation rate or procedure time did not differ significantly between the 3 groups.ConclusionsWater insufflation was superior to air or carbon dioxide for pain tolerance. This was seen in the subgroups with BMI <18 kg/m2 and the post-surgical group, but not in the group with BMI >30 kg/m2.

| S-EPMC5934604 | biostudies-literature

A randomized, controlled, double-blind trial of air insufflation versus carbon dioxide insufflation during ERCP.

Project description:Visualization during GI endoscopy requires distention of the bowel lumen. Carbon dioxide (CO(2)) insufflation decreases postprocedure abdominal discomfort and distension after colonoscopy, but there have been few published studies on its use in ERCP.To assess the safety and efficacy of CO(2) insufflation during ERCP.Double-blind, controlled, randomized trial.Tertiary-care referral center.This study involved consecutive patients referred for ERCP, excluding those with known CO(2) retention or with chronic use of opiate medications.Insufflation of CO(2) versus insufflation of air.Primary outcomes were abdominal pain assessed on a visual analogue scale and abdominal distension. Secondary outcomes included transcutaneous CO(2) levels (pCO(2)) and procedural complications.We analyzed 74 patients, 38 in the air group and 36 in the CO(2) group. Pain scores were similar in both groups 1-hour postprocedure (16 vs 11 mm in the CO(2) and air groups, respectively; P = .29) as well as over the subsequent 24 hours. There were also no significant differences between groups in abdominal distension or pCO(2) levels. There were 13 patients with complications in the air group and 5 in the CO(2) group (P = .04; nominal significance removed by Bonferroni correction), although most complications were minor in nature.Single-center study.The use of CO(2) for insufflation during ERCP was safe in a tertiary-care referral population. However, use of CO(2) during ERCP did not lead to decreased postprocedural pain or less abdominal distension, so its role in this procedure remains in question. NCT00685386.

| S-EPMC2902617 | biostudies-literature

Carbon dioxide insufflation during screening unsedated colonoscopy: a randomised clinical trial.

Project description:One of the methods used to reduce pain and discomfort during colonoscopy is insufflation of carbon dioxide instead of air. However, the actual benefit of carbon dioxide insufflation is not unequivocally proven. The aim of the study was to evaluate the advantages of carbon dioxide insufflation during screening colonoscopy. A total of 200 patients undergoing screening colonoscopy between 2010 and 2011 were included in the prospective, randomized study carried out in a surgical referral center. Screening unsedated colonoscopy with either air or carbon dioxide insufflation was performed; patients were randomly assigned to air or carbon dioxide group by means of computer-generated randomization lists. All examinations were performed in an ambulatory setting with standard videocolonoscopes. The main outcomes analyzed were (a) duration of the entire procedure, (b) cecal intubation time, and (c) pain severity immediately, 15, and 60 min after the procedure. Group I included 59 women and 41 men and group II included 51 women and 49 men. The duration of the procedure was circa 10 min in both groups. Pain score values immediately and 15 min after the procedure were similar in both groups (P=0.624 and 0.305, respectively). A lower pain score was observed only after 60 min in patients insufflated with carbon dioxide (1.28 vs. 1.54, P=0.008). No pain reduction was observed in women and in obese patients (BMI>30). Carbon dioxide insufflation during unsedated screening colonoscopy does not decrease the duration of the procedure and appears to reduce pain intensity at 60 min after examination to an extent without clinical significance. The study was registered at ClinicalTrials.gov, number NCT01461564.

| S-EPMC4495875 | biostudies-literature

Phrenic nerve preservation using carbon dioxide insufflation during sinus node ablation procedure.

Project description: Not available

| S-EPMC8134789 | biostudies-literature

A Construction of Cancer Registry and Prospective Korean Medicinal Cancer Cohort Study in East-West Cancer Center, Dunsan Korean Medicine Hospital of Daejeon University : Focused on Lung, Breast, Stomach, Colorectal, Liver, Uterine and Ovarian Cancers

Project description:Primary outcome(s): Disease-free survival (DFS) Study Design: Observational Study Model : Cohort, Time Perspective : Prospective, Enrollment : 172, Biospecimen Retention : Collect & Archive- Sample without DNA, Biospecimen Description : Whole blood, plasma, WBC, RBC

| 2510317 | ecrin-mdr-crc

Multimarker in normal colorectal mucosa to predict occurrence of colorectal neoplasm

Project description:Primary outcome(s): Association of Mulkimarker expression pattern and synchronous neoplasm Study Design: Observational Study Model : Case-control, Time Perspective : Others, Enrollment : 50, Biospecimen Retention : Collect & Archive- Sample with DNA, Biospecimen Description : Tissue sample

| 2508885 | ecrin-mdr-crc

Serum trefoil factor family 3 as a biomarker in Korean patients with colorectal cancer

Project description:Primary outcome(s): level of serum trefoil factor family 3 Study Design: Observational Study Model : Case-control, Time Perspective : Prospective, Enrollment : 200, Biospecimen Retention : Collect & Archive- Sample without DNA, Biospecimen Description : serum, colonic mucosa tissue

| 2511406 | ecrin-mdr-crc

Analgesic efficacy of dexmedetomidine in patients undergoing laparoscopic colorectal cancer surgery

Project description:Primary outcome(s): postoperative pain score Study Design: Observational Study Model : Cohort, Time Perspective : Retrospective, Enrollment : 160, Biospecimen Retention : Not collect nor Archive

| 2514216 | ecrin-mdr-crc

Peritoneal Tumorigenesis and Inflammation are Ameliorated by Humidified-Warm Carbon Dioxide Insufflation in the Mouse.

Project description:BackgroundConventional laparoscopic surgery uses CO2 that is dry and cold, which can damage peritoneal surfaces. It is speculated that disseminated cancer cells may adhere to such damaged peritoneum and metastasize. We hypothesized that insufflation using humidified-warm CO2, which has been shown to reduce mesothelial damage, will also ameliorate peritoneal inflammation and tumor cell implantation compared to conventional dry-cold CO2.MethodsLaparoscopic insufflation was modeled in mice along with anesthesia and ventilation. Entry and exit ports were introduced to maintain insufflation using dry-cold or humidified-warm CO2 with a constant flow and pressure for 1 h; then 1000 or 1 million fluorescent-tagged murine colorectal cancer cells (CT26) were delivered into the peritoneal cavity. The peritoneum was collected at intervals up to 10 days after the procedure to measure inflammation, mesothelial damage, and tumor burden using fluorescent detection, immunohistochemistry, and scanning electron microscopy.ResultsRapid temperature control was achieved only in the humidified-warm group. Port-site tumors were present in all mice. At 10 days, significantly fewer tumors on the peritoneum were counted in mice insufflated with humidified-warm compared to dry-cold CO2 (p < 0.03). The inflammatory marker COX-2 was significantly increased in the dry-cold compared to the humidified-warm cohort (p < 0.01), while VEGFA expression was suppressed only in the humidified-warm cohort. Significantly less mesothelial damage and tumor cell implantation was evident from 2 h after the procedure in the humidified-warm cohort.ConclusionsMesothelial cell damage and inflammation are reduced by using humidified-warm CO2 for laparoscopic oncologic surgery and may translate to reduce patients' risk of developing peritoneal metastasis.

| S-EPMC4687477 | biostudies-literature

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